Secondary progressive multiple sclerosis (SPMS) is the second most common type of multiple sclerosis, a demyelinating syndrome of the central nervous system. Previous studies have suggested that B-cells have a prominent role in the pathogenesis of MS. Rituximab, a monoclonal CD20 antibody, may affect the B-cell population within the central nervous system (CNS) through depletion of the peripheral B-cell compartment. The purpose of this cohort study of 88 patients with SPMS was to analyze disability progression in patients with SPMS treated with rituximab compared with matched control patients never treated with rituximab. Disability was measured using the Expanded Disability Status Scale (EDSS) score. Researchers found that after a mean follow-up of 3.5 years for patients treated with rituximab and 4.8 years in the control group, patients who had received rituximab had significantly lower EDSS scores with a mean difference of -0.52 (95% CI -0.79 to -0.26, p<0.001). Additionally, the time to progression of disability was prolonged in the group treated with rituximab (HR 0.49, 95% CI 0.26 to 0.33, p=0.03). Investigators therefore concluded that rituximab therapy for SPMS resulted in lower EDSS scores and delayed disability progression, as compared to matched patients who did not receive rituximab therapy.
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